Survey Shows Strong Member Support
for Development of Treatment Outcome Measures

ASBMT members voiced strong support for their society developing measures of treatment outcomes, provided that those measures are accurate, useful and fairly applied.

In an online survey in May, members were asked their opinions about efforts to create a standardized system for measuring and reporting outcomes of hematopoietic cell therapy.  A strategy and the reasons for the effort were outlined in a “white paper” published in the May issue of Biology of Blood and Marrow Transplantation. 

Among the survey findings:

• 96% said that the society should provide advice to government agencies and third-party payers on the development of measures of treatment outcomes.
  
  
• 89% said that the society should develop a model protocol for the comprehensive measurement and reporting of center-specific treatment outcomes.
  
  
• 83% said that the society-developed protocol should include both autologous and allogeneic transplants.
  
  
• 94% agreed with an approach to outcome measurement that would recognize the diversity of individual programs, be based on quality assurance and improvement, and minimize the administrative burdens of data collection.

“It was gratifying to see the number of members who provided thoughtful comments and observations to the open-end question at the end of the survey,” said Dr. Roy Jones, chair of the ASBMT Committee on Hematopoietic Cell Transplant Quality Outcomes.  His committee authored the white paper that laid out the reasons for developing outcome measures at this time.

Those comments ranged from strongly supportive . . .

• “I applaud the ASBMT for tackling this very difficult issue.”
  
  
• “The BMT community, through ASBMT, should clearly take the lead in this important initiative.”
  
  
• “I think that it is best for us to be ahead of the trend rather than trying to catch up.”

. . . to highly skeptical:

• “Outcomes should not be center-specific.  Because of the diversity among centers, outcomes from center to center can never be truly comparable.”
  
  
• “FACT certification should be satisfactory to evaluate transplant center performance, rather than a new, unmandated treatment outcomes measuring tool.”

Many emphasized that ASBMT should develop the measurement tools in cooperation with other organizations in the hematopoietic cell therapy field such as the CIBMTR, NMDP, FACT and ISCT.  “This is exactly the approach that we want to take,” Dr. Jones said.  “I think we’ll be successful to the degree that our organizations can pool their expertise and experience.”

The white paper outlined reasons for the development of treatment outcome measures at this time:

• The recently enacted Stem Cell Therapeutic and Research Act of 2005 will require all U.S. centers performing allogeneic transplants to begin reporting each allogeneic transplant patient's outcome to a central registry.
  
  
• Third-party payers have expressed a desire to have more detailed treatment outcome information for reimbursement decisions and for designating centers of excellence.  Some already are moving in this direction.
  
  
• The Outcomes Committee has determined that valid outcome measures from transplant centers can be determined only through comprehensive confidential reporting of individual patient data to a central registry.
  
  
• Patients and referring physicians increasingly are seeking treatment outcome information for making informed decisions about health care.
  
  
• Solid organ transplants already have a sophisticated system for measuring and reporting treatment outcomes through comprehensive collection of individual patient data.

The white paper takes the position that ASBMT should become involved in the development of protocol for center-specific treatment outcome measurement and reporting because the alternative is measurement systems that are imposed by entities outside the BMT community.

As one survey respondent summed it up:  “I am pleased that ASBMT is taking this initiative instead of third-party payers and government agencies to assure this is done in the most useful and helpful way possible.”

All ASBMT members were invited in a May 10 broadcast e-mail to participate in the online survey.  Responses were received from 176 members.

The ASBMT Executive Committee will be receiving monthly updates on the progress of the Committee on Hematopoietic Cell Transplant Quality Outcomes, and reports will appear regularly in ASBMT print and online publications.  Members are encouraged to continue to provide their comments and recommendations as the program unfolds.